Hip Instability

The hip plays an important role in supporting the upper body weight while standing, walking and running, and hip stability is crucial for these functions. The femur (thigh bone) and acetabulum (hip bone) join to form the hip joint, while the labrum (tissue rim that seals the hip joint) and the ligaments lining the hip capsule maintain the stability of the hip. Injury or damage to these structures can lead to a condition called hip instability. Hip instability happens when the hip joint becomes unstable causing various symptoms.

Symptoms

The most common symptoms of hip instability include

Pain

Laxity

Giving away of the hip

Producing a clicking sound

Dislocation

Causes

Hip instability can be traumatic or atraumatic. Traumatic instability can be caused by injuries from sports or motor vehicle accidents. These injuries can damage the bony structures, labrum, and cartilage of the hip joint and can form loose bodies. It can range from severe dislocation to a simple subluxation (partial displacement) of the hip joint. Atraumatic instability can be caused by overuse or developmental/congenital abnormalities of the hip joint.

Conditions that can cause hip instability include:

Labral and ligament tears

Hip dysplasia (misaligned hip joint bones)

Femoroacetabular impingement (abnormally shaped hip joint bones)

Tears to the ligamentum teres

Prior surgery to the hip in which the capsule was not repaired

Diagnosis

Dr. Mansour will diagnosis hip instability based on your medical history and physical examination. Imaging studies such as plain X-rays, MRI, and MRI arthrography (use of a contrast agent) may also be ordered to confirm instability. Dr. Mansour may also perform hip instability tests such as posterior impingement, dial test, or axial distraction test; all of which involve moving the hip into various positions to test the stability of the joint.

Treatment

Dr. Mansour may start you off on a conservative/non-operative treatment approach such as protected weight bearing (crutch, cane, or wheelchair) and referral to a physical therapist for exercises. A physical therapist will instruct on special exercises, focused on improving your strength, balance, and flexibility.

When conservative options fail to resolve your symptoms or if you have large fractures, you may be recommended to undergo surgical management. Surgery can be arthroscopic (minimally invasive) or open depending on your condition. Most of the common causes for hip instability, such as damage to the hip capsule and ligaments surrounding the joint, and labral tears can be rectified arthroscopically. Dr. Mansour will be the best person to address your concerns and help you overcome your instability.